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https://www.readbyqxmd.com/read/29908930/the-effect-of-computed-tomography-scans-oriented-along-the-longitudinal-scaphoid-axis-on-measurements-of-deformity-and-displacement-in-scaphoid-fractures
#1
Adnan N Cheema, Paul J Niziolek, David Steinberg, Bruce Kneeland, Nikolas H Kazmers, David Bozentka
PURPOSE: Reformatting computed tomography (CT) scans along the scaphoid longitudinal axis improves the ability to detect scaphoid fractures compared with reformats along the wrist axis. However, it remains unclear whether scaphoid axis reformats affect measurements of displacement or deformity, which are factors that drive the clinical decision to perform open reduction internal fixation. Our null hypothesis was that reformatting CT scans along the scaphoid axis does not affect measurements of fracture displacement and deformity...
June 13, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29907373/effect-of-trochleocapitellar-index-on-adult-patient-reported-outcomes-after-noncomminuted-intra-articular-distal-humeral-fractures
#2
Giuseppe Rollo, Roberto Rotini, Denise Eygendaal, Paolo Pichierri, Michele Bisaccia, Ante Prkic, Alessandro Stasi, Luigi Meccariello
BACKGROUND: Anatomic surgical reduction of intra-articular fractures of the distal humerus is important to achieve the best long-term outcomes and prevent post-traumatic arthritis. In this study we compared the radiographic reduction using the trochleocapitellar index. We also correlated the trochleocapitellar index to the functional outcomes next to the comparison of the triceps brachii lifting approach and olecranon osteotomy approach, 2 common approaches for distal humeral fractures...
July 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29906380/points-pearls-managing-shoulder-injuries-in-the-emergency-department-fracture-dislocation-and-overuse
#3
Richard Pescatore, Andrew Nyce, Nachi Gupta, Jeffrey Nusbaum
The complex structures of the shoulder can be injured by fracture, dislocation, and overuse, and correctly identifying and classifying injury is essential to avoiding pain, disability, and life- and limb-threatening complications. This issue presents a systematic approach to classifying shoulder injuries based on the mechanism of injury and clinical presentation, choosing appropriate imaging, and determining the best strategies for treatment, including reduction, surgical consultation, or outpatient referral...
June 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29904502/traumatic-lipohemobursa-of-the-infrapatellar-bursa
#4
Segen Aklilu, Gregor M Dunham, Felix S Chew
Displaced fractures allow spillage of bone marrow and blood into the surrounding soft tissues. When the fracture is intra-articular, the spilled marrow contents may be contained by the associated joint capsule, resulting in a lipohemarthrosis. This is sometimes visible as a fat-fluid level on imaging. At the knee, the characteristic appearance of lipohemarthrosis within the suprapatellar recess signifies the presence of an intra-articular fracture that may otherwise not be radiographically apparent. We present a case in which an extra-articular proximal tibia fracture allowed spillage of marrow contents into the deep infrapatellar bursa, resulting in a lipohemobursa...
April 2018: Radiology Case Reports
https://www.readbyqxmd.com/read/29901478/coronal-fracture-of-the-lunate-in-advanced-kienb%C3%A3-ck-disease-reestablishing-midcarpal-congruency-to-enable-osteochondral-reconstruction-a-case-report
#5
Joshua A Gillis, James P Higgins
CASE: We describe a patient with Bain grade-2b Kienböck disease with a coronal fracture of the distal lunate articular surface with proximal structure collapse. To reestablish midcarpal congruity, we used a bone-anchored suture to repair the coronal split in the lunate in preparation for lunate preservation with osteochondral medial femoral trochlea (MFT) reconstruction. CONCLUSION: In Bain grade-2b Kienböck disease, lunate reconstruction of both the proximal and distal joint surfaces can be performed...
June 13, 2018: JBJS Case Connector
https://www.readbyqxmd.com/read/29896026/results-of-ring-ilizarov-fixator-in-high-energy-schatzker-type-vi-fractures-of-proximal-tibia
#6
Ujjwal Kanti Debnath, Dipak Kumar Jha, Prasanta Kumar Pujari
Background: High-energy fractures of proximal tibia (Schatzker VI) are associated with severe articular depression, separation of both condyles, diaphyseal comminution & dissociation with loss of integrity of the soft-tissue envelope. Complications of plating are well known since last 50years in these difficult fractures. An alternative method was proposed by Ilizarov (ring fixator) and was adopted for the treatment of these complex injuries. Aim of study: To analyse the results of patients who had ring fixator for the management of high-energy fractures (Schatzker VI) of the proximal tibia...
April 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29896019/osteochondritis-dissecans-does-platelet-rich-plasma-really-help
#7
Deepak Kumar Sharma, Narendra Kumar, Hitesh Lal, Binay Kumar Sahu, Sumon Singphow Saikia
Osteochondritis dissecans is a common disorder of knee and can be treated by various methods, depending on age of patient and stability of chondral fragment. In Osteochondritis dissecans ICRS type III lesion i.e. articular cartilage discontinuity but no dislocation, variable rate of union as well as high rate of non-union was observed in previous studies when treated with arthroscopic or open reduction and fixation. In previous study it has been also shown that platelet rich plasma help in fracture healing...
April 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29895090/-arthroscopically-assisted-minimally-invasive-fixation-of-a-type-d2c-scapular-fracture
#8
Patrick Kornherr, Christiane Konerding, Mark Kovacevic, Klaus Wenda
Fractures of the scapula are rare and have an incidence of 1% of all fractures. Publications highlight glenoid rim fractures. Classification by Ideberg and Euler and Rüdi are accepted. Euler and Rüdi describe three extra-articular and two intra-articular fracture patterns. The indications for surgery are displaced glenoid fractures, scapula tilt of more than 40° and injuries to the superior shoulder suspensory complex. We describe a case of a 22 year old man, who while cycling collided with a moving car due to wet roads...
June 12, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29891266/bennett-fractures-a-biomechanical-model-and-relevant-ligamentous-anatomy
#9
Jason R Kang, Anthony W Behn, Joseph Messana, Amy L Ladd
PURPOSE: This study examined a palmar beak fracture model to determine which thumb carpometacarpal (CMC) joint ligament is the primary ligament relevant to the pattern of injury. METHODS: Six fresh-frozen cadaveric wrists were used. The radius, ulna, and first metacarpal were secured and tested with a materials testing system, holding the wrist in 20° extension, 20° ulnar deviation, and 30° palmar abduction of the first metacarpal. Testing consisted of preconditioning cycles followed by compressive loading at 100 mm/s...
June 8, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29891210/bi-planar-intra-articular-deformity-following-malunion-of-a-schatzker-v-tibial-plateau-fracture-correction-with-intra-articular-osteotomy-using-patient-specific-guides-and-arthroscopic-resection-of-the-tibial-spine-bone-block
#10
Joseph Pagkalos, Robert Molloy, Martyn Snow
Malunited tibial plateau fractures are a surgical challenge. We report a case of a malunion following a Schatzker V tibial plateau fracture with a biplanar deformity of the medial hemi-plateau. This was treated with an intra-articular osteotomy and biplanar restoration of the medial hemi-plateau using patient-specific guides and 3-dimensional planning based on computed tomography (CT) images. The mechanical axis was paradoxically preserved and the lateral compartment showed evidence of overload and degeneration secondary to a malunited tibial spine bone block providing varus/valgus constraint...
June 8, 2018: Knee
https://www.readbyqxmd.com/read/29891131/anatomic-feasibility-of-distal-fibula-bicortical-screw-fixation-with-lateral-neutralization-plating-for-rotational-ankle-fractures
#11
Laura E Sansosti, Andrew J Meyr
A common technique for fixation of rotational fibular fractures is to use an interfragmentary compression screw with a laterally positioned neutralization plate. The objective of the present investigation was to examine the anatomic feasibility of distal fibula bicortical fixation within this plating technique. A specific screw insertion technique was performed through a laterally positioned one-third tubular plate on a consecutive series of 81 intact cadaveric ankle mortises. The most distal plate hole was drilled, aimed 10° posterior to the midline of the fibula...
June 8, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29887918/cement-augmentation-of-humeral-head-screws-reduces-early-implant-related-complications-after-locked-plating-of-proximal-humeral-fractures
#12
J Christoph Katthagen, O Lutz, C Voigt, H Lill, A Ellwein
Background: Cement augmentation (CA) of humeral head screws in locked plating of proximal humeral fractures (PHF) was found to be biomechanically beneficial. However, clinical outcomes of this treatment have not been well evaluated to date. Objectives: To assess outcomes of locked plating of PHF with additional CA and to compare them with outcomes of conventional locked plating without CA. Methods: 24 patients (mean age, 74.2 ± 10.1 years; 22 female) with displaced PHF were prospectively enrolled and treated with locked plating and additional CA...
2018: Obere Extremität
https://www.readbyqxmd.com/read/29887632/cuboid-injuries
#13
Ippokratis Pountos, Michalis Panteli, Peter V Giannoudis
Cuboid fractures are rare injuries. A number of different treatment methods have been proposed including plaster immobilization, open reduction, and internal fixation or external fixation. Bone grafting is commonly used to restore bony length. The majority of the current literature suggests that the loss of length of the lateral column and articular congruency are the two criteria opting for the surgical management of these fractures. Nevertheless, the exact indications and ideal management of these fractures are not established mainly due to the rarity of these injuries and the paucity of literature...
May 2018: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29887628/management-of-talar-body-fractures
#14
S R Sundararajan, Abdul Azeem Badurudeen, R Ramakanth, Shanmuganathan Rajasekaran
Fractures of talar body are uncommon injuries often associated with fractures of other long bones and in polytraumatized patients. The integrity of the talus is essential for the normal function of the ankle, subtalar, and midtarsal joints. The relative infrequency of this injury limits the number of studies available to guide treatment. They occur as a result of high-velocity trauma and are therefore associated with considerable soft tissue damage. Axial compression with supination or pronation is the common mechanism of injury...
May 2018: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29887624/the-open-envelope-approach-a-limited-open-approach-for-calcaneal-fracture-fixation
#15
Sharad Prabhakar, Mandeep S Dhillon, Ankit Khurana, Rakesh John
Background: Minimally invasive surgery (MIS) has a significant and evolving role in the treatment of displaced intra articular calcaneal fractures (DIACFs), but there is limited literature on this subject. The objective was hence to assess the clinicoradiological outcomes of DIACFs fixed with an innovative open-envelope MIS technique. Materials and Methods: 42 closed Sanders Type 2 and 3; DIACFs were included in this study. The Open-envelope approach was developed, which is essentially a limited open, dual incision, modified posterior longitudinal approach allowing excellent visualisation and direct fragment manipulation...
May 2018: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29887503/incidence-and-risk-factors-of-knee-injuries-associated-with-ipsilateral-femoral-shaft-fractures-a-multicentre-retrospective-analysis-of-429-femoral-shaft-injuries
#16
Seong-Eun Byun, Hyun-Chul Shon, Jai Hyung Park, Hyoung Keun Oh, Young-Ho Cho, Ji Wan Kim, Jae-Ang Sim
A femoral shaft fracture is usually a high-energy injury and, thus, is likely to be accompanied by an injury of adjacent joints such as a knee ligament injury. However, these associated injuries are often neglected because of severe pain and deformity. The purpose of the current study is to evaluate the incidence, type and risk factors of ipsilateral knee injuries associated with femoral shaft fractures. A total of 429 femoral shaft fractures were included in this study from January 2010 to September 2015. There were 320 males and 109 females, with mean age of 40...
June 4, 2018: Injury
https://www.readbyqxmd.com/read/29885963/variables-affecting-functional-outcome-in-floating-knee-injuries
#17
Mahesh Suresh Kulkarni, Monappa Naik Aroor, Sandeep Vijayan, Saurabh Shetty, Sujit Kumar Tripathy, Sharath K Rao
BACKGROUND: The surgical outcome of floating knee injuries is difficult to predict. The high-velocity nature of the injury, complex fracture pattern and associated soft tissue/visceral injuries may have some impact on the functional outcome. The present study evaluates the variables affecting the clinical and radiological outcomes of floating knee injuries. MATERIALS AND METHODS: The clinical, radiological and functional outcome (Karlstrom and Olegrud criteria) of 89 patients with 90 floating knee injuries were evaluated at the end of one year who were managed in our level 1 trauma center between January 2013 and December 2016...
June 1, 2018: Injury
https://www.readbyqxmd.com/read/29884320/transient-retrograde-interfragmentary-compression-technique-in-ao-ota-type-33-c-distal-femur-fractures-a-surgical-technique-and-short-term-radiographic-follow-up-results
#18
Yoon Young Choi, Seung Joon Rhee, Jae Yoon Jeong
Surgical treatment of AO/OTA type 33-C fractures is a therapeutic challenge despite advances in surgical instruments and techniques. We introduce a novel surgical technique named transient retrograde interfragmentary compression (TRIC) to help intraarticular fragment reduction in AO/OTA type 33-C fracture. We inserted a partial threaded 7.0-cannulated screw with a washer along the transepicondylar axis from the medial femoral epicondyle during the articular block reduction process of AO/OTA type 33-C fractures to strengthen the compressive force between the condylar fragments and to enhance the handling of the articular block fragment in the alignmental correction stage...
June 4, 2018: Injury
https://www.readbyqxmd.com/read/29883511/nonoperative-treatment-of-closed-extra-articular-distal-humeral-shaft-fractures-in-adults-a-comparison-of-functional-bracing-and-above-elbow-casting
#19
H J Christiaan Swellengrebel, David Saper, Paul Yi, Alexander A Weening, David Ring, Andrew Jawa
Diaphyseal fractures of the distal humerus have a high rate of union when treated with a functional brace or an above-elbow cast (AEC). This study compares alignment of the humerus and motion of the elbow after functional brace or AEC treatment. One-hundred and five consecutive patients with a closed, extra-articular fracture of the distal humeral diaphysis were identified in the orthopedic trauma databases of 3 hospitals between 2003 and 2012. Seventy-five patients with a follow-up of at least 6 months or with radiographic and clinical evidence of fracture union were included (51 treated with functional bracing and 24 treated with an AEC)...
May 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29881694/medial-patellofemoral-ligament-reconstruction-using-all-soft-suture-anchors-for-patellar-fixation
#20
Justin L Makovicka, David E Hartigan, Karan A Patel, Sailesh V Tummala, Anikar Chhabra
The medial patellofemoral ligament (MPFL), which is critical for both patellar stability and normal kinematics of the patellofemoral joint, is disrupted in most patellar dislocations. Consequently, MPFL reconstruction is advocated in recurrent dislocations to restore native patellar constraints. Fixation of the MPFL graft to the medial border of the patella can be achieved through various methods, each with its own benefits and drawbacks. We present a technique for MPFL fixation to the patella using all-soft suture anchors, theoretically decreasing the risk of patellar fracture and articular surface violation...
March 2018: Arthroscopy Techniques
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